The South West Aftercare service (SW Aftercare) is based at the
Bristol Royal Hospital for Children (BRHC), and the Bristol
Haematology and Oncology Centre (BHOC), both part of University
Hospitals Bristol (UHBristol) NHS Foundation Trust. Which hospital
you are seen in will depend on your age when you come to
clinic.

SW Aftercare is a clinical service dedicated to the care and
support of teenagers and young adults who were treated for cancer
or leukaemia (or certain related conditions) from the ages of 0-24.
It aims to provide you with information about your treatment and
its possible effects on your future health. By offering you an
individualised assessment and by providing you with recommendations
for future monitoring, we hope we will help you understand whether
there are any concerns about your health now or in the future.

If any problems do occur, we are able to refer you
to other specialists for help and support.

If you are already being treated for problems relating to your
cancer treatment, we will try to help co-ordinate your care and
ensure that special knowledge about the consequences of cancer
treatment in childhood is shared with any other doctors you may be
seeing.

The review that you receive will consider all aspects of your
health and be undertaken by various professionals who specialise in
this area of healthcare.

If you reside within the South West and think you would be
eligible for review by the Aftercare Team then you can self-refer.
Just call the team on 0117 342 8607, or if you would prefer, your
GP can also make a referral on your behalf.

The SW Aftercare Team is made up of doctors, a nurse specialist
and a Macmillan support worker. Once you have attended clinic, you
will be provided with a treatment summary for your records and an
up to date care plan outlining the information that was discussed
during the consultation. This information is also shared with your
GP so that they are aware of your healthcare needs.

Macmillan Support Worker

Macmillan support workers are not nurses, but are allied health
professionals (AHPs) that work with nurses and doctors to try and
improve your wellbeing. As well as helping you to access local
services, they can also provide information on how to deal with the
long-term physical and psychological effects of treatment, and how
you can get in touch with healthcare professionals if you have any
concerns. The Macmillan support worker is also your first point of
contact for the service should you have any questions or queries
related to your aftercare.

Macmillan Support Worker: Divya Bassi

Clinical Nurse Specialist (CNS)

CNS's working within Aftercare hold many years of experience of
cancer and its treatment. They have specialist knowledge on living
with and beyond a cancer diagnosis and the long term effects that
the treatment can have. Their assessment will include determining
your level of understanding of your previous diagnosis and
treatment including a discussion about healthy lifestyle issues and
a review of any new problems, current medical treatment and the
health of your family.

Aftercare Clinical Nurse Specialist: Ruth
Elson

Aftercare Doctors

The doctors who will review you within an Aftercare clinic are
experts in treating patients with cancer and the long term effects
that they can cause. They undertake a detailed review of your
previous treatment and a discussion of what this means for your
future health. The doctor will be able to answer any questions you
may have and will undertake a physical examination as appropriate
related to the things you have discussed together. Before the
consultation ends, the doctor will talk to you about the next steps
and agree your care plan with you.

Endocrine Doctors

If you have possible (or already established) hormone problems,
you may also see another doctor who is an endocrinologist (hormone
specialist). This review will take place separately to your other
consultations but will be held in the same location and on the same
day if possible. You will receive a separate letter with
information about this appointment and the doctor will send an
additional letter to you and your GP to outline what was
discussed.

Endocrine consultants: Dr Karin Bradley and Dr Bushra
Ahmad

Do I have to attend SW aftercare clinics?

Attendance at the clinic is an optional part of your care after
completing treatment for cancer. Nevertheless, we strongly
recommend that all young people are given the opportunity to be
seen in a SW aftercare clinic at some point so that we can help
them decide what they want to do about follow up in the future.

Normally we offer appointments to anyone who is 16 years or over
and for whom at least five years has passed since their cancer
diagnosis (and at least three or more years since they completed
treatment). However, our appointment rules are flexible and we
sometimes we see people even when they do not fit these
criteria.

We also run clinics for patients aged 11 to 15 years.

How often will I need to come to the SW aftercare clinic?

How often you come to clinic after your first assessment depends
on what you and the aftercare team decide. It will depend on
whether we think you need any tests or if we suggest there are
reasons why you need to be monitored more carefully. This will be
discussed with you the first time you come to clinic.

Many of our patients attend the clinic only once a year or at
less frequent intervals. After a time, we may agree that there is
no need for someone to continue to attend the clinic. If this is
the case for you, we will provide you and your GP with all the
information we think you need for the future. Even if you no longer
attend clinic, you and your GP will still be able to contact us for
advice and information via our Macmillan support worker. If
necessary, we will arrange for you to return to see us in clinic
and this can be done without any worry about the need for formal
re-referral.

What about seeing my GP and other health professionals?

SW aftercare clinics are not meant to replace the relationship
that you have with your GP or with any other health professionals
you may be seeing.

We want to provide you with information about your previous
cancer treatment that will help you and your GP to decide if any
special care needs to be taken over your healthcare in the
future.

We will usually write letters to you after each clinic visit and
copy it to your GP and, with your permission, to anyone else who
may be involved in your care. These letters will provide a record
of the plan we make with you in clinic - this is your care
plan.

After your first visit to the SW Aftercare clinic we will also
provide you with a copy of a record of your previous treatment.
This is your treatment summary. You may find it helpful to share
this, and your care plan, with any other doctors you see in the
future.

What things are likely to be discussed with me in clinic?

Apart from talking about your current health and whether or not
you have any new concerns, we will usually talk to you, when
appropriate, about some or all of the following things:

Understanding your cancer and its treatment

Referral to other professionals or specialist teams if
needed

The need for any additional tests or check-ups

Healthy lifestyle advice

Support in making health care decisions

Fertility advice

Advice about education and employment

Advice about benefits and insurance

Psychological support.

Can I bring someone with me to clinic?

Yes. You are welcome to bring your partner or a friend if you
would like their support. In the past you probably came to clinic
with your parents and they are still welcome to come with you.
However, we also think it helpful that you try to have at least
part of your consultation alone as this may help you to ask
questions that you could find difficult to ask when others are
present.

All the information you share with us will be treated in the
strictest confidence.

How long does my appointment last?

The first visit to SW Aftercare can take at least an hour. We
hope you will find it useful to have such an in-depth review and
that you can make the time available. Follow up appointments are
usually allocated for up to half an hour. Given the complicated
nature of some of our discussions, we sometimes fail to keep to
time. We try to avoid this as far as is possible but apologise if
you ever find your own appointment is delayed.

Who can I contact about my appointment or if I have a question
or query for the team?

Your first point of contact for the aftercare service is the
Macmillan support worker who will deal with your requests
appropriately whether this is through them or by passing onto
another member of the team depending on the query.

Who do I contact if I develop a new symptom or feel
unwell?

SW Aftercare clinics are not meant to replace the relationship
that you have with your GP or with any other health professionals
you may be seeing. If you feel unwell you should book an
appointment with your registered practice that will be able to
manage your needs appropriately. You can also contact the Aftercare
team so that they can update your medical records at the hospital
and or if you need the team to speak to other professionals on your
behalf.

What is a care plan?

We will usually write letters to you after each clinic visit and
copy it to your GP and, with your permission, to anyone else who
may be involved in your care. These letters will provide a record
of the plan we make with you in clinic - this is your care plan. If
you receive your care plan and have any questions about its content
or want to change something then please do contact the team and we
would be happy to discuss this with you.

What is a treatment summary?

After your first visit to the SW Aftercare clinic we will also
provide you with a copy of a record of your previous diagnosis and
treatment. This is your treatment summary. You may find it helpful
to share this, and your care plan, with any other doctors you see
in the future.

This page contains links
to useful organisations and websites. If there is
anything not listed here that you have found helpful and you think
it may benefit others, please let us know.

For more information on support that is available, please
visit or contact the Informtion and Support
Centre which is located in the Bristol Haematology and Oncology
Centre foyer. Tel: 0117 342 3369

To arrange a specialist aftercare review for your patient please
contact our Macmillan Support Worker on 0117 342 8607 or send
referral information for the attention of the aftercare team
to:

Oncology Day Beds

Level 6

Bristol Royal Hospital for Children

Upper Maudlin Street

Bristol

BS2 8BJ

Our service

The South West Aftercare service (SW Aftercare) is based at the
Bristol Royal Hospital for Children (BRHC), and the Bristol
Haematology and Oncology Centre (BHOC), both part of University
Hospitals Bristol (UHBristol) NHS Foundation Trust. Which hospital
you are seen in will depend on your age when you come to
clinic.

SW Aftercare is a clinical service dedicated to the care and
support of teenagers and young adults who were treated for cancer
or leukaemia (or certain related conditions) from the ages of 0-24.
It aims to provide you with information about your treatment and
its possible effects on your future health. By offering you an
individualised assessment and by providing you with recommendations
for future monitoring, we hope we will help you understand whether
there are any concerns about your health now or in the future.

If any problems do occur, we are able to refer you
to other specialists for help and support.

If you are already being treated for problems relating to your
cancer treatment, we will try to help co-ordinate your care and
ensure that special knowledge about the consequences of cancer
treatment in childhood is shared with any other doctors you may be
seeing.

The review that you receive will consider all aspects of your
health and be undertaken by various professionals who specialise in
this area of healthcare.

If you reside within the South West and think you would be
eligible for review by the Aftercare Team then you can self-refer.
Just call the team on 0117 342 8607, or if you would prefer, your
GP can also make a referral on your behalf.